Clever Han(d)s Skepticism and “Ido in Autismland”

Ido in Autismland: Climbing out of Autism’s Silent Prison is included on proponent lists as evidence that Facilitated Communication (FC) works. The book focuses on traditional, touch-based FC and Rapid Prompting Method (RPM), where the facilitator holds a letter board in the air and/or cues from a distance. To date, there is no reliably controlled evidence to prove that facilitated messages are produced independently and the book fails to offer further insights, except to say we’re supposed to believe in FC because the author(s) say so.

Attempt at self-awareness with Clever Hans. (Karl Krall, Thinking Animals, Plate 3, 1907).

Yoram Bonneh’s foreword sets the tone by attempting to cast doubt on “Clever Hans skepticism.” Clever Hans was a horse purportedly able to solve math problems and spell words. The trick fooled many people because the trainer’s cues were so subtle, most people missed them altogether. The illusion unraveled when onlookers discovered the horse could not answer questions to which the trainer was unaware.

Bonneh astutely points out that humans are not horses. Apparently, he wants readers to think human-to-human cuing is not possible. The Clever Hans effect, or ideomotor response, is not about the horse nor is it limited to animal tricks.

The scientific community first documented the ideomotor response in the mid-1800s and linked it to activities such as dowsing, automatic writing and the use of a planchette. Illusionists and magicians have for decades knowingly exploited verbal and non-verbal cuing to trick and entertain their audiences. Practitioners of Applied Behavior Analysis (ABA) (demonized in the book) are also aware of the adverse effects of cuing when instructing their clients.

By 2012, when Ido in Autismland was published, researchers had solidly linked facilitator cuing to FC and many organizations adopted opposition statements that are still in effect.

When facilitators are reliably blinded to test protocols, the resulting responses fall into three categories: 1) facilitator known responses, 2) unintelligible, and 3) correctly spelled words that are not relevant to the materials presented (e.g., facilitator generated messages).

RPM and Spelling to Communicate are clever solutions to the question of “Who is doing the pointing?” but fail to address authorship. Cuing can and does occur without the facilitator touching the individual being facilitated. A person’s ability to follow cues to select letters on a keyboard does not guarantee comprehension or literacy skills.

Tracy Kedar understood the problems of facilitator cuing when she started using FC with her son. Ido was four years old when she held his elbow and pointed to character names in “The Jungle Book.”

True to what research shows (see Kezuka, 1997; Burgess, 1998, Wegner 2003), the movements felt real to Kedar. She describes this feeling as a connection to her son, an intimacy that previously had not existed. At her husband’s request, they set up a test to determine authorship. Although Kedar was convinced that her son had miraculously learned to read by staring at an alphabet poster, street signs and license plates, Ido’s responses were unintelligible unless Kedar held his elbow. Though not totally convinced it did not work, she abandoned FC for a time.

Ido and his facilitator using a “hands-off” style of facilitated communication called Rapid Prompting Method. Ido extends a finger toward the letter board while the facilitator holds it in the air. Cuing occurs as the facilitator moves the board backwards and forwards, up and down to assist with letter selection. (Friendship Circle, Chabad Telethon, 2008).

In sharp contrast to the relative ease and intimacy of FC, Kedar’s experience of managing her son’s education and therapies was overwhelming. She describes this time as all-consuming. They spent 40 hours a week on ABA, speech/language therapy, occupational therapy, and other instruction. Despite everyone’s efforts, Ido remained unable to speak. His behaviors were impulsive, repetitive, and, at times, aggressive. He snatched things, dashed into the street, stimmed, and showed little progress.

By the time Kedar decided to try FC again, she was exhausted and felt all the ABA techniques had backfired. Experts, to her, had turned into “experts” as she lost faith in their ability to cure Ido’s autism. She especially resented them when they told her FC had no evidence behind it and they had concerns about facilitator cuing.

Kedar’s belief in FC crystallized when her son was seven. She used a hand-over-hand technique with Ido holding a pencil to spell out B-I-R-T-H-D-A-Y. They went on to correctly spell all the names of the people they were inviting to his party. This time, she writes, she knew—KNEW—she wasn’t helping him.

As a double-blind test, her husband suggested Ido tell her about an event that happened without his mother’s presence (e.g., “Tell mom where we went today”). The facilitated message was clear: Don’t test. Apparently, Ido was too anxious to facilitate with his mother when she did not already know the answer.

Instead of relying on fact-based information, Kedar proved to herself that FC “worked” with what she called “incidental double-blind proof.” These were typed messages at home that seemingly correlated with activities at school or facilitated discussions involving shared experiences, like the birthday party. 

Kedar ended up firing the ABA team. As described in the book, she surrounded herself with people who either knew nothing about autism or who believed in FC.

Around this same time, Kedar met Soma Mukhopadhyay, the inventor of RPM, who Kedar speaks of in biblical terms. Ido worked with Soma for 6 months learning how to point to the letterboard Mukhopadhyay held in the air. Kedar mentions, but downplays, the fact that RPM is not evidence-based and relies on facilitator cuing. She’s willing to take Mukhopdhyay’s claims of independent communication on faith and considers anyone who doubts FC to be against individuals with autism. To Kedar, the fact that Ido could point to a letter board without physical touch proved the facilitated messages were his. She vehemently denies providing inadvertent cues.

Ido’s facilitator uses hand signals to cue letter selection. The position of the hand is within Ido’s peripheral vision. (Ido Answers FAQ, Ido in Autismland, 2013)

What Kedar fails to reveal in the book, however, is her deliberate use of hand signals to cue Ido in selecting letters. These 2013 YouTube Videos show her using a variety of hand shapes just inside Ido’s peripheral vision. (See Ido Answers FAQ (1) (1/2); Ido Answers FAQ (1) (2/2)). These changes in hand shapes coincide with Ido’s hand movements.

While the typed answers are attributed to Ido, Kedar’s involvement in the typing activity is evident as she shifts her body weight, rests her arm on the table and changes hand shapes to cue letter selection. Her eyes are almost always directed to the keyboard.

Another video from 2019 shows Kedar continuing to cue Ido during letter selection. About 11 seconds in, Ido is shown pointing to a letter board held in the air. Then, the scene changes to show Ido selecting letters on a stationary keyboard. Kedar shifts her body and moves her head as Ido’s hand moves in synchronicity. The video is edited to make it look like Ido communicates independently, but slowed down, Kedar’s behaviors during the facilitated sessions raises questions about authorship.

It is not possible to tell from YouTube videos and books like Ido in Autismland the independent language and literacy skills facilitated individuals have. It is possible that, with prolonged practice, these individuals have begun to recognize and anticipate common spelling patterns (e.g., “h” often follows “t”). It is also possible they have developed some language and literacy skills from facilitated drills that, according to Virginia Breen’s account, can be as intense as the rejected ABA exercises.

What these videos and books can do is give insight into the thoughts, motivations, and behaviors of facilitators. There is no doubt that raising a child with profound autism is stressful and overwhelmingly challenging. As Kedar says, parents are put in the position of having to make quick decisions about treatments and therapies they may or may not know anything about. These families often struggle to find any kind of equilibrium as their emotional, physical, and financial resources are stretched to the limits. And, even when families provide their children with the best educational and medical resources, their child’s disabilities may not be overcome in the way they hope.

For all its flaws as an independent communication technique (it cannot work), FC appears to be an activity that gives some parents a sense of control. In Kedar’s case, she reduced the number of people involved with her son’s education and literally took his communication needs into her own hands. Psychologically, this must have been a relief after years of what she considered to be limited or no meaningful communication with her son.

FC, for those who believe in it, seems to answer the question of what is going on in the minds of individuals with profound communication needs. As facilitators convince themselves of their abilities to “converse” with their loved ones, their awareness of their own actions decreases. Facilitator cuing is integral to how FC “works,” and facilitators are motivated to remember the times FC confirms their beliefs (e.g., so-called incidental double-blind proof) but forget the times it does not (e.g., when Ido cannot relay information to his father that his mother/facilitator does not know).

FC is more aligned with a belief system than a communication technique. Until facilitators are willing to be intellectually and emotionally honest about the effects of cuing on the typing activity, we cannot accept FCed messages as independently representing those who are being subjected to it.